Labour came to power almost five years ago, partly on the premise that it would improve the ailing and failing National Health Service.

Despite following the previous Conservative government in putting more money into the NHS in real terms, it has not achieved its objective.

Now Health Secretary Alan Milburn is proposing further changes, which include allowing the private sector to take hold of failing health trusts and letting the best ones opt out of state control.

There is some merit in allowing good hospitals to have more control of their own affairs, getting rid of the dead hand of regional and national control. Similar reforms in education have worked well.

But it's hard to imagine that private control of a trust facing difficulties such as Brighton Health Care would bring much improvement.

Many of those problems are outside the trust's control, including a lack of funding, a shortage of nursing home beds, staff shortages and rising demand for services.

Booting out chief executive Stuart Welling and his team would simply lead to a lot of redundancy payments.

Labour, and a lot of the public, are still wedded to an outmoded concept of the NHS as a free cradle-to-the-grave service, fine in 1948 but not in 2002.

Mr Milburn should look at more successful schemes in other countries and assess whether new methods of funding would work rather than tinkering with trusts.